1.Radiological protection detection and dose assessment of selective internal radiotherapy with 90Y resin microspheres
Dexing LIAN ; Shanshan KOU ; Jianfei LU ; Qingzhao ZHANG ; Weiguo ZHU ; Chuanjian WANG ; Changsong HOU
Chinese Journal of Radiological Medicine and Protection 2022;42(5):385-390
Objective:To conduct radiation detection and dose assessment in selective internal radiotherapy with 90Y resin microspheres for the purpose of providing a reference for radiological protection. Methods:The dose rates from radiotherapy with 90Y resin microspheres were detected in the process of each operation at different distances from the body surface of patients the levels of dose to the persons concerned were compared with the relevant national regulations and standards. Results:The estimated dose rates were 1.12-454 μSv/h during 90Y resin microspheres dispensing and 2.06-58.2 μSv/h during surgical procedure. The dose rates at 0.5 h after surgery were 22.7-64.1 μSv/h at 5 cm and 0.82-2.55 μSv/h at 1 m from three patient′s body surface. Assuming treating 200 patients a year, the annual individual effective dose to the radiation workers was 0.12-1.03 mSv/year. The annual individual effective dose to the public, comforters and carers of patients was 0.02-0.24 mSv/year after release of a patient. Conclusions:During the treatment, nursing and release of patients, the radiation doses to workers, carers and the public are lower than the individual dose limit given in the GB18871-2002 basic standards for protection against ionizing radiation and for the safety of radiation sources and the management target value set by of the relevant medical institutions.
2.Measurement and analysis of 90Y radioactivity in urine of patients treated with 90Y resin microspheres
Dexing LIAN ; Shanshan KOU ; Jianfei LU ; Jun CHAO ; Zaiyun ZHU ; Qingzhao ZHANG ; Changsong HOU
Chinese Journal of Radiological Medicine and Protection 2022;42(6):460-463
Objective:To evaluate 90Y activity concentration in renal excretions during the first 48 hours after being treated with 90Y resin microspheres seleceive internal radiation therapy(SIRI) and to provide advice on the management of patient excreta after surgery. Methods:After surgery, urine excreted from 3 patients during 0-24 h and 24-48 h was collected respectively, and the 90Y activity concentration in urine was tested and analyzed. Results:90Y radioctivity in the urine excreted from 3 patients after surgery was (1 266±258)kBq/GBq during 0-24 h and (140±106) kBq/GBq during 24-48 h, respectively, and 90Y activity concentration were (640±113) kBq/L during 0-24 h and (53±12) kBq/L during 24-48 h. Conclusions:90Y radioactivity in patient′s urine excreted at 1 d was about 10 times higher than that at 2 d. After surgery, patients can accelerate the reduction of free 90Y activity by increasing excretion. Urine excreted by the patients during hospitalization should be handled in accordance with the requirements of the national standard HJ 1188-2021 Radiation protection and safety requirements for nuclear medicine.
3.Shielding calculation and discussion on high energy light source storage ring and synchrotron
Zhen ZHANG ; Xuetao WANG ; Changsong HOU ; Dexing LIAN ; Weiguo ZHU ; Fei CHEN ; Yuwen LI
Chinese Journal of Radiological Medicine and Protection 2021;41(2):146-150
Objective:To verify and discuss the consistency and applicability of the semi empirical formula and Monte Carlo simulation method in the radiation shielding calculation for high energy synchrotron radiation source.Methods:The semi empirical formula and Monte Carlo simulation were used to calculate the ambient dose equivalent outside of the shielding.Results:The ratio of Jenkins semi empirical formula result to Monte Carlo simulation result was 111%-153%. The ratio of Sakano semi empirical formula result to Monte Carlo simulation result was 201%.Conclusions:For a single shielding material, the semi empirical formula can be simple and conservative to complete the shielding calculation for high-energy electron accelerator. For a variety of shielding materials, Monte Carlo simulation method should be used.
4.Analysis of external exposure dose during 131I treatment for thyroid cancer patient
Qingzhao ZHANG ; Wenliang LI ; Weiguo ZHU ; Jing LIANG ; Dexing LIAN ; Changsong HOU
Chinese Journal of Radiological Medicine and Protection 2021;41(5):353-357
Objective:To explore the existing issues in radiation protection during the treatment of 131I by means of measuring the ambient dose equivalent rate to patients with thyroid cancer and the dose equivalent to the surface of chest of patients during hospitalization. Methods:The ambient dose equivalent rate (peer) was measured by using gamma ray detector for selected 78 patients who received 131I treatment in a hospital 10 min, 1 d, 2 d, 3 d and 5 d after administration with 131I. The measurements were made at distances of 5 cm, 0.5 m and 1 m from the body surface in front, rear, left and right directions. The photoluminescence dosimeter on the chest of the patients was used to measure the effective dose during hospitalization period (6 d). Results:The ambient dose equivalent rate on the surface of chest of patients was up to 4.81 mSv/h 10 min after administration of medicine. The dose equivalent on the surface of chest of patients before discharge ranged 2.6-64.1 μSv/h. The cumulative dose on chest surface during hospitalization was 15.9-58.8 mGy. There was a significant difference in the dose rate at 5 cm from the body surface between 3.7 GBq group and 5.55 GBq group 10 min after medication ( t=-6.11, P<0.05). There was a significant difference in the dose rate at 5 cm from the body surface between male and female groups 10 min after medication ( t=4.52, P < 0.05). There was no significant difference in other groups ( P > 0.05). Conclusions:During the 131I treatment, patients had high level of radiation around them, so it is necessary to strengthen the protection and management of patients and reduce unnecessary exposure to the public.
5.Implementation of survey on diagnostic medical X-ray frequency in 2016 in China
Jing LIANG ; Qingzhao ZHANG ; Weiguo ZHU ; Dexing LIAN ; Zhen ZHANG ; Changsong HOU
Chinese Journal of Radiological Medicine and Protection 2019;39(5):321-324
To ascertain the background and frequency of diagnostic medical X-ray procedures in China and provide the basis for regulatory oversight of such applications,a total of 557 medical institutions in 25 provinces or municipalities were surveyed by means of the optimally designed questionnaires and through stratified quota sampling.The numbers of procedures were calculated in terms of the type of procedures and the sex and age of examined patients.As a result,the frequencies of diagnostic X-ray procedures for 2016 in the country were derived using multiple linear regression analysis.The frequency of X-ray diagnosis in 10 provinces of China in 2016 was estimated to be 379-1 228 examinations per 1 000 population.Diagnostic X-ray applications have shown a rapid expansion in 2016 as compared with the period of "9th Five-Year Plan".It is very important to strengthen the regulation of medical diagnostic X-ray applications.
6. Study on the optimization of radiation protection for therapeutic proton synchrotron
Weiguo ZHU ; Jing LIANG ; Changsong HOU ; Dexing LIAN ; Zhen ZHANG
Chinese Journal of Radiological Medicine and Protection 2019;39(9):707-710
Objective:
To investigate the effect of iron shield at different depths within main protection wall on the dose rate outside the protection wall.
Methods:
By adopting the FLUKA code, a therapeutic room model was constructed with its primary protective barrier consisting of concrete and iron. In order to obtain its ambient dose equivalent rate distribution, the 250 MeV protons and 220 MeV protons impinging on water phantom were simulated separately.
Results:
With varying depth of iron plate embedded in barrier, the ambient dose equivalent rates in the two simulated conditions differed sinificantly at 30 cm outside the protection wall. The maximum ambient dose equivalent rate(220 MeV: 3.42 μSv/h, 250 MeV: 6.39 μSv/h) was more than 2 times higher than the minimum ambient dose equivalent rate(220 MeV: 1.75 μSv/h, 250 MeV: 3.32 μSv/h).
Conclusions
In the design of therapeutic proton accelerator, it is essential to evaluate carefully the location where the iron shield is in main protection wall.
7.Analysis of intercomparison results for radon-thoron discriminative detector
Yanchao SONG ; Hongxing CUI ; Qingzhao ZHANG ; Dexing LIAN ; Changsong HOU ; Yunyun WU
Chinese Journal of Radiological Medicine and Protection 2018;38(12):938-941
Objective To increase the cumulative measurement level of 222 Rn and 220 Rn and ensure the accuracy and reliability of the measurement result . Methods By using improved 222 Rn-220 Rn discriminative detectors ( LD-P detectors) , the radon research group of National Institute for Radiological Protection Chinese Center for Disease Control and Prevention participated with the intercomparison organized by National Institute of Radiological Science ( NIRS) , Japan. Specifically, with the 222 Rn-220 Rn discriminative detectors being sent to Japan, the comparison was completed under different conditions in the 222 Rn chamber and 220 Rn chamber in NIRS. After exposure, the detectors were sent back to our laboratory for etching and analysis, and then measurement result were informed to NIRS. Finally, NIRS returned the exposure reference values of 222 Rn and 220 Rn to our laboratory. Results Under the conditions of high and low levels of 222 Rn, the relative percentage differences ( RPD ) between the measured values and the reference value provided by the NIRS were -12. 0% and -11. 8%, respectively, while coefficients of variation ( COV) were 3. 0% and 6. 2%, respectively. Under the conditions of high level and low levels of 220Rn, the relative percentage differences (RPD) between the measured value and the reference value provided by the NIRS were -0. 8% and -8. 0%, respectively; coefficients of variation ( COV ) were 6. 7% and 4. 5%, respectively. Conclusions This intercomparison result were categorized by NIRS ( PRD<10%) , with the satisfactory result of LD-P detectors available.
8.Comparative study of diffusion kurtosis imaging model and diffusion weighted imaging model in diagnosisofbreastcancer
Ting LI ; Lunbo LU ; Yaoyao ZHUO ; Jingge LIAN ; Dexing KONG ; Yun XIONG ; Kangan LI
Chinese Journal of Radiology 2018;52(3):177-182
Objective To compare the value of diffusion kurtosis imaging (DKI) model with single-index DWI model parameters in the differential diagnosis of benign and malignant breast lesions,and to explore the correlation between the parameters and molecular subtypes and prognostic factors of breast cancer.Methods A retrospective analysis was performed with inclusion of 64 cases of breast diseases from January 2016 to May 2017 in Shanghai First People's Hospital.The patients were pathologically confirmed and typed, 30 cases are malignant tumors and 34 cases are benign lesions. DKI and DWI were performed within 2 weeks before the pathological examination. Invasive ductal carcinoma of grade Ⅰ, Ⅱ and Ⅲ were revealed in 1, 7 and 13 cases respectively. Luminal A breast cancer was found in 10 cases, Luminal B breast cancer was diagnosed in 11 cases, HER-2 positive breast cancer was 4 cases and triple negative breast cancer was 5 cases. The expressions of estrogen receptor (ER), Progesterone receptor (PR), and HER-2 positive were found in 20, 14 and 15 cases respectively. Ki67 was highly expressed in 24 cases and low expression in 6 cases. All patients underwent both plain and enhanced mammography scanning. The kurtosis (MK), mean diffusivity (MD) and ADC value were measured. Prognosis analysis was performed according to the maximum diameter (>2 cm, ≤2 cm), vascular or neurological invasion (positive, negative), lymph node metastasis (positive, negative), ER (positive, negative), PR (positive, negative), HER-2 (positive, negative),Ki67 (positive, negative), pathological grade (grade Ⅰ+Ⅱ,Ⅲ). Two independent samples t test was used to compare DKI and DWI parameters between benign and malignant lesions. ROC analysis was performed for assessing the values of parameters in discriminating benign and malignant breast lesions. Mann-Whitney U and Kruskal-Wallis H tests were used for the comparison of various prognostic factors or molecular subtypes.Spearman rank correlation analysis was used to explore the correlation of different prognostic factors and DKI and DWI parameters. Results The MK value of malignant group was higher than that of benign group,and the MD value and ADC value were lower than that of benign group (P<0.05). The area under the ROC for MK, MD and ADC were 0.897, 0.827 and 0.776, respectively. The area under the ROC was improved to 0.935 when three parameters were combined. The MK of ER positive group was higher than that of negative group (P<0.05). There was no significant difference of parameters among the other prognostic groups (all P>0.05). There was a low positive correlation between ER and MK (r= 0.417, P= 0.022). There was no correlation between the other prognostic factors and parameters (r=-0.086 to 0.313, all P>0.05). There was no significant difference in the MD, MK and ADC values among the four different subtypes of breast cancer (all P>0.05). Conclusions MK, MD and ADC values can be used to discriminate benign and malignant breast tumors, among which MK value has the best diagnostic performance. There is a certain correlation between DKI model parameters and prognostic factors.
9.Diagnostic value of diffusion kurtosis imaging combined with quantitative dynamic contrast-enhanced MRI in breast lesions
Ting LI ; Lunbo LU ; Yaoyao ZHUO ; Jingge LIAN ; Dexing KONG ; Yun XIONG ; Kang'an LI
Chinese Journal of Radiology 2018;52(6):436-441
Objective To evaluate the diagnostic efficacy of MRI diffusion kurtosis imaging (DKI) and quantitative dynamic contrast enhancement MRI (DCE-MRI) in benign and malignant breast lesions, and to explore the differential diagnosis ability for different pathological types and molecular subtype lesions. Methods Sixty four females were retrospectively enrolled in the study of MRI diffusion kurtosis imaging and quantitative dynamic contrast enhancement between November 20 and May 2017. All of them were confirmed to have benign or malignant lesions after surgical resection or puncture. All patients underwent axial T1WI, DKI and DCE-MRI examinations. The mean kurtosis (MK) and mean diffusivity (MD) values were calculated by the DKI model, and the hemodynamic parameters were obtained by quantitative dynamic contrast enhancement, including volume transfer constant (Ktrans), rate constant (Kep), extravascular extracellular space distribute volume per unit tissue volume (Ve) and blood volume fraction (Vp). Pathological analysis was performed to monitor the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2) and nuclear proliferation index Ki67. The breast cancer was divided into Luminal A type, Luminal B type, HER-2 positive and triple-negative 4 subtypes. The differences of DKI parameters and DCE-MRI parameters between benign and malignant breast lesions were compared using two independent samples t test (normal distribution and homogeneity of variance) or Mann-Whitney U test (skewed distribution or variance). ROC analysis was used to evaluate the value of DKI and DCE-MRI parameters in differential diagnosis of benign and malignant breast lesions with pathological results as the gold standard. The Mann-Whitney U test and Kruskal-Wallis H test were used to compare the differences of DKI and DCE-MRI parameters among different prognostic factors and molecular subtypes of breast cancer. Spearman rank correlation analysis was used to evaluate the correlation between DKI and DCE-MRI parameters and different prognostic factors. Results Sixty-four cases were single lesions, with breast cancer in 23 cases and 41 cases of benign lesions. In breast cancer, there were 9 cases of Luminal A type, 7 cases of Luminal B type, 3 cases of HER-2 positive type and 4 cases of triple negative type. The positive numbers of ER, PR and HER-2 were 14, 11 and 10 cases respectively. Nineteen cases showed high expression of Ki67, while 4 cases showed low expression. There were significant differences in MK, MD, Ktrans and Kep between benign and malignant lesions (P<0.05). However, there was no significant difference between Ve and Vp (P>0.05). The area under the ROC for the differential diagnosis of benign and malignant breast lesions were 0.897, 0.808, 0.844 and 0.842, respectively. The combined multi-parameter differential diagnosis improved the efficacy. Combined with the above four parameters, the area under the ROC was 0.950. The diagnosis Sensitivity, specificity and accuracy were 0.870, 0.951 and 0.922 respectively. The Ktrans and Vp values of patients with ER positive and ER negative, as well as Ve value of deferent lymph node status, were significantly different (P<0.05), but there was no significant difference between the other prognostic factors (P>0.05). There was a moderate positive correlation between ER and Ktrans and Vp values. There was a low positive correlation between lymph node status and Ve value (r= 0.6, 0.5 and 0.4, respectively, P<0.05). No correlation was found among other parameters and prognostic factors (P>0.05). There were no significant differences in DKI and DCE-MRI parameters among different subtypes of breast cancer patients (all P>0.05). Conclusion DKI combined with DCE-MRI can improve the differential diagnosis of breast lesions and some DCE-MRI parameters are related to prognostic factors.
10.Validation and discussion of the time response correction formula for radiation detectors
Zhen ZHANG ; Dexing LIAN ; Changsong HOU ; Qingzhao ZHANG ; Hui XU ; Weiguo ZHU ; Jing LIANG
Chinese Journal of Radiological Medicine and Protection 2018;38(1):48-51
Objective To validate and discuss the time response correction formula for four types of dosimeters (6150AD6 + 6150AD-b,FH40G + FHZ672E-10,451P ionization chamber and AT1123).Methods The ambient dose equivalent rates shown by survey meters were recorded separately when X-ray emission time was 500,200,100 and 50 ms.The corrected values were obtained by the formula of circuit having a capacitance C and asistance R in series.Results Therewas no correlation between the value measured by AT1123 dosimeter and the time of irradiation.The values by other three kinds of dosimeters obviously varied with the time of irradiation.Conclusions It is not required to make the time response correction for the measured value of ATl123 dosemeter,whereas the values measured by the other three dosimeters could be corrected by the time response correction formula.

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